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Cardiac Auscultation Practice - S4 Gallop

S4: add this extra heart sounds by tapping first finger twice

Setup:
Auscultation Practice - S4 ... Gallop S4: add ... ptfaddenMD #S3 #Gallop
Double Apical Impulse (S4) Visualization on Physical Exam - Hi-Res Video Version: https://www.grepmed.com/images/7802/physicalexam-cardiology-impulse-double-gallop-apical-signs

On palpation, the PMI
Apical Impulse (S4 ... physicalexam-cardiology-impulse-double-gallop-apical-signs ... A prominent S4 sound ... The S4 sound is ... #Gallop #PhysicalExam
Double Apical Impulse (S4) Visualization on Physical Exam - A small stick taped to the chest
Apical Impulse (S4 ... had a prominent S4 ... Apical #Impulse #S4 ... #Gallop #PhysicalExam
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
tachycardia • S3, S4 ... or summation gallop
Apical Impulse Waveforms on Physical Examination
- Normal
- Sustained Palpable S4
- "Triple Ripple"
- Palpable S3

#Apical #Impulse #Waveforms
Sustained Palpable S4
Cardiac Auscultation Practice - S3 Gallop

S3: add this extra heart sound by tapping second finger twice

Setup:
Practice - S3 Gallop ... ptfaddenMD #S3 #Gallop
Conjunctival Pallor: Image on left shows the pale appearance of the conjunctival reflection (lower lid) in
Conjunctival Pallor ... Images #Clinical #Photo ... #Conjunctival #Pallor
HFrEF - Low Ejection Fraction on Physical Exam - Likelihood Ratios
 - Displaced Apical Impulse
 -
Respirations - S3 Gallop
Scarlet fever
• Delayed-type skin reactivity to pyrogenic exotoxin Requires prior exposure
• Diffuse erythematous eruption that generally
- circumoral pallor ... diagnosis #clinical #photo
Varying Degrees of Palpebral Conjunctival Pallor in four patients with hemoglobin levels:
(a) 7.3
(b) 12.7
(c) 14.0
(d) 14.5

#Conjunctival
Palpebral Conjunctival Pallor ... #Conjunctival #Pallor